How much rates vary
Facilitymedian $2,188 · 10th to 90th $692 to $7,079Professionalmedian $1,445 · 10th to 90th $724 to $2,042
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $691.83 Median $1,288.25 Typical High $8,317.64 | Facility | None | $691.83 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $812.83 | Professional | None | $691.83 | $691.83 | $812.83 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,754.23 Typical High $7,079.46 | Facility | None | $1,778.28 | $2,754.23 | $7,079.46 |
BCBS North Carolina Setting Professional Modifier None Typical Low $870.96 Median $1,548.82 Typical High $2,041.74 | Professional | None | $870.96 | $1,548.82 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,238.72 Typical High $3,235.94 | Facility | None | $645.65 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $1,737.80 | Professional | None | $776.25 | $812.83 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,174.90 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,258.93 Typical High $2,951.21 | Facility | None | $602.56 | $1,258.93 | $2,951.21 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,174.90 | Professional | None | $831.76 | $933.25 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,737.80 | Professional | None | $602.56 | $776.25 | $1,737.80 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $346.74 Typical High $398.11 | Professional | 52 · Reduced service | $346.74 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $158.49 | Professional | 53 · Discontinued | $141.25 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $602.56 | Professional | 54 · Surgery only | $524.81 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $120.23 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $79.43 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $562.34 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $707.95 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $295.12 | $707.95 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $426.58 Median $501.19 Typical High $851.14 | Professional | 51 · Multiple procedures | $426.58 | $501.19 | $851.14 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $199.53 Typical High $338.84 | Professional | 80 · Assistant surgeon | $169.82 | $199.53 | $338.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $120.23 Median $138.04 Typical High $239.88 | Professional | 81 · Minimal assistant surgeon | $120.23 | $138.04 | $239.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $120.23 Median $138.04 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $120.23 | $138.04 | $239.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $138.04 Typical High $239.88 | Professional | AS · PA/NP assist | $120.23 | $138.04 | $239.88 |
Where North Carolina sits
The same service costs 8.5 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
North Carolina· 7th of 51
$1,445
AK $2,951TX $347
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.